A Consultation About Breast Augmentation?

A 46 year-old woman Rib cage=33 inches Around the fullest part of her bust=36.5 inches 1 Best brand of implants? 2 Which size? What will post-op size be? 3 Same implant size for both of the breasts? or should the right one be larger? 4 Silicone or saline? 5 Above or partially under or completely under the pectoralis? 6 Smooth or textured? 7 Round or anatomical? 8 Is it recommended via the transaxillary incision? 9 Could you recommend a surgeon in Syria or nearby? Any American surgeon? Thanks

Doctor Answers 4

Round silicone gel retro-pectoral is best

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You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape the breast tissue creating upper pole fullness, displace the breast higher on the chest wall and more medial to increase cleavage.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall will give maximum anterior projection with a minimal size implant.  I always recommend silicone gel implants placed retro-pectoral since they look and feel more natural and have less rippling.  Smooth implants are better than textured in the retro-pectoral position and round is better in case of rotation.  The implant profile is irrelevant in the retro-pectoral position since the muscle compresses it.  I never use a transaxillary incision.  At size 36 each 200 cc's of implant corresponds to 1 cup size change.  From this, you can calculate the size implant you would require to achieve your desired goal.

Best Wishes,

Gary Horndeski, M.D. 

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

A Consultation About Breast Augmentation?

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          Breast augmentation after previous breast surgery will be far more challenging.  The pockets and implants will probably have to be adjusted intraoperatively to get the best result.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Silicone or saline implants okay.

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There is enough breasts tissue that silicone or saline implants should be satisfactory. I would recommend saline implants be placed under the pectoralis muscle. I do not use texturized implants because they have no aesthetic benefit and a higher failure and contour irregularity rate.

Breast Augmentation Consult?

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Thank you for the question and pictures. The asymmetry that you are referring to is clearly demonstrated in the photographs. It is clear that additional “maneuvers” will be necessary on the right breast to improve symmetry.

 The questions that you have asked are excellent questions that will be addressed in formal consultation. You may find attached link, discussing many of these issues at length, helpful to you as well.

Although potentially useful to some degree, online “consultations” cannot be as precise as necessary. Ultimately, careful communication of goals, careful measurements (dimensional planning),  careful selection of appropriate breast implants and skillful execution of the procedure will be important steps in achieving your goals.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this (and the attached link) help.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.